Long-term effects of calcium-vitamin-D3-fortified milk on bone geometry and strength in older men

The long-term effects of calcium and vitamin D supplementation on bone material and structural properties in older men are not known. The aim of this study was to examine the effects of high calcium (1000 mg/day)- and vitamin-D3 (800 IU/day)-fortified milk on cortical and trabecular volumetric BMD (vBMD) and bone geometry at the axial and appendicular skeleton in men aged over 50 years. One hundred and eleven men who were part of a larger 2-year randomized controlled trial had QCT scans of the mid-femur and lumbar spine (L1–L3) to assess vBMD, bone geometry and indices of bone strength [polar moment of inertia (Ipolar)]. After 2 years, there were no significant differences between the milk supplementation and control group for the change in any mid-femur or L1–L3 bone parameters for all men aged over 50 years. However, the mid-femur skeletal responses to the fortified milk varied according to age, with a split of ≤62 versus >62 years being the most significant for discriminating the changes between the two groups. Subsequent analysis revealed that, in the older men (>62 years), the expansion in mid-femur medullary area was 2.8% (P < 0.01) less in the milk supplementation compared to control group, which helped to preserve cortical area in the milk supplementation group (between group difference 1.1%, P < 0.01). Similarly, for mid-femur cortical vBMD and Ipolar, the net loss was 2.3 and 2.8% less in the milk supplementation compared to control group (P < 0.01 and <0.001, respectively). In conclusion, calcium–vitamin-D3-fortified milk may represent an effective strategy to maintain bone strength by preventing endocortical bone loss and slowing the loss in cortical vBMD in elderly men.

Using shopping mall attributes to revitalise Australian small town retailing

As has occurred in many smaller rural communities in America, Europe and Canada much of inland Australia has experienced population decline involving both a net loss of people a disproportionate ageing of the population and low average family incomes. Some Australian country towns have ceased to function as retail and administrative centres while other rural areas are faced with the prospect of losing critically important retail outlets and service providers. Australian rural towns are under threat from residents outshopping at nearby large regional centres leading to the loss of businesses and services in small service towns. This paper explores the possibility of how and why retailers and service providers in Australian country towns can and should emulate certain attributes of shopping malls in an attempt to stem the rise of outshopping. Using data collected in one small Australian rural community the paper comments on residents' perceptions of the strengths and weaknesses of retailing and the provision of services in their local community and what respondents thought should be done to diminish retail leakage from their town. Based on their responses it is clear that to remain competitive, retailers in smaller rural towns need to learn from the experience of shopping malls with whom they must now compete to survive. In this paper, it is argued that in certain areas this is not only possible, but essential if retailing is to remain viable in Australian country towns.

Towards a standardised methodology for estimating alcohol-caused death, injury and illness in Australia

Two key methodological issues underlying different methods for calculating estimates of the number of alcohol-caused deaths are identified and recommendations suggested for future work.

1. How to adjust alcohol aetiologic fractions across time and place to reflect different levels of risky drinking. A common approach is outlined for both acute and chronic alcohol-related conditions. In the absence of consistent, reliable and regionally specific measures of the prevalence of risky alcohol consumption from national surveys, the use of per capita consumption data as a means of adjusting alcohol population aetiologic fractions over time and across regions is recommended.

2. Whether abstainers or low-risk drinkers should be used as the reference group when assessing the impact of alcohol consumption and how the resulting information is best presented. It is recommended that when abstainers are used as the reference group, the costs and benefits for both 'low-risk' and 'risky/high-risk' drinking should be identified. Using this approach, it was estimated that for Australia in 1998 there was a net benefit of 5,100 lives saved due to low-risk drinking, while there was a net loss of 2,737 lives due to risky/high-risk drinking. On its own, the figure of a net saving of 2,363 lives per year is a simplistic and potentially misleading picture of alcohol as a net benefit to public health and safety. For public health communications, there is still value in providing estimates using the low-risk drinking contrast, of the number of lives saved if risky/high-risk drinkers all became low-risk drinkers (n=3,292 in 1998). The use of the abstinence contrast, however, allows the more complex picture of alcohol's impact on public health to be apparent, e.g. including the estimated 1,505 deaths associated with low-risk drinking (mostly from cancer).

Corner inlet and Nooramunga habitat mapping project

Deakin University and the University of Tasmania were commissioned by Parks Victoria (PV) to create two updated habitat maps for areas within the Corner Inlet and Nooramunga Marine and Coastal Park and Ramsar area. The team obtained a ground-truth data set using in situ video and still photographs. This dataset was used to develop and assess predictive models of benthic marine habitat distributions incorporating data from both ALOS (Advanced Land Observation Satellite) imagery atmospherically corrected by CSIRO and LiDAR (Light Detection and Ranging) bathymetry. This report describes the results of the mapping effort as well as the methodology used to produce these habitat maps.

Overall accuracies of habitat classifications were good, returning overall accuracies >73 % and kappa values > 0.62 for both study localities. Habitats predicted with highest accuracies included Zosteraceae in Nooramunga (91 %), reef in Corner Inlet (80 %), and bare sediment (no-visible macrobiota/no-visible seagrass classes; both > 76 %). The majority of classification errors were due to the misclassification of areas of sparse seagrass as bare sediment. For the Corner Inlet study locality the no-visible macrobiota (10,698 ha), Posidonia (4,608 ha) and Zosteraceae (4,229 ha) habitat classes covered the most area. In Nooramunga no-visible seagrass (5,538 ha), Zosteraceae (4,060 ha) and wet saltmarsh (1,562 ha) habitat classes were most dominant.

In addition to the commissioned work preliminary change detection analyses were undertaken as part of this project. These analyses indicated shifts in habitat extents in both study localities since the late 1990s/2000. In particular, a post-classification analysis highlighted that there were considerable increases in seagrass habitat (primarily Zosteraceae) throughout the littoral zones and river/creek mouths of both study localities. Further, the numerous channel systems remained stable and were free of seagrass at both times. A substantial net loss of Posidonia in the Corner Inlet locality is likely but requires further investigation due to potential misclassifications between habitats in both the 1998 map (Roob et al. 1998) and the current mapping. While the unsupervised Independent Components Analysis (ICA) change detection technique indicated some changes in habitat extent and distribution, considerable areas of habitat change observed in the post-classification approach are questionable, and may reflect misclassifications rather than real change. A particular example of this is an apparent large decrease in Zosteraceae and increase in Posidonia being related to the classification of Posidonia beds as Zosteraceae in the 1998 mapping. Despite this, we believe that changes indicated by both the ICA and post-classification approaches have a high likelihood of being ‘actual’ change. A pattern of gains and losses of Zosteraceae in the region north of Stockyard channel is an example of this. Further analyses and refinements of approaches in change detection analyses such as would improve confidence in the location and extent of habitat changes over this time period.

This work has been successful in providing new baseline maps using a repeatable method meaning that any future changes in intertidal and shallow water marine habitats may be assessed in a consistent way with quantitative error assessments. In wider use, these maps should also allow improved conservation planning, advance fisheries and catchment management, and progress infrastructure planning to limit impacts on the Inlet environment.

Reversing diet-induced metabolic dysregulation by diet switching leads to altered hepatic de novo lipogenesis and glycerolipid synthesis

In humans, low-energy diets rapidly reduce hepatic fat and improve/normalise glycemic control. Due to difficulties in obtaining human liver, little is known about changes to the lipid species and pathway fluxes that occur under these conditions. Using a combination of stable isotope, and targeted metabolomic approaches we investigated the acute (7–9 days) hepatic effects of switching high-fat high-sucrose diet (HFD) fed obese mice back to a chow diet. Upon the switch, energy intake was reduced, resulting in reductions of fat mass and hepatic triacyl- and diacylglycerol. However, these parameters were still elevated compared to chow fed mice, thus representing an intermediate phenotype. Nonetheless, glucose intolerance and hyperinsulinemia were completely normalized. The diet reversal resulted in marked reductions in hepatic de novo lipogenesis when compared to the chow and HFD groups. Compared with HFD, glycerolipid synthesis was reduced in the reversal animals, however it remained elevated above that of chow controls, indicating that despite experiencing a net loss in lipid stores, the liver was still actively esterifying available fatty acids at rates higher than that in chow control mice. This effect likely promotes the re-esterification of excess free fatty acids released from the breakdown of adipose depots during the weight loss period.

Blood pressure change with weight loss is affected by diet type in men

Background: Weight loss reduces blood pressure, and the Dietary Approaches to Stop Hypertension (DASH) diet has also been shown to lower blood pressure.

Objective: Our goal was to assess the effect on blood pressure of 2 weight-reduction diets: a low-fat diet (LF diet) and a moderate-sodium, high-potassium, high-calcium, low-fat DASH diet (WELL diet).

Design: After baseline measurements, 63 men were randomly assigned to either the WELL or the LF diet for 12 wk, and both diet groups undertook 0.5 h of moderate physical activity on most days of the week.

Results: Fifty-four men completed the study. Their mean (±SD) age was 47.9 ± 9.3 y (WELL diet, n = 27; LF diet, n = 27), and their mean baseline home systolic and diastolic blood pressures were 129.4 ± 11.3 and 80.6 ± 8.6 mm Hg, respectively. Body weight decreased by 4.9 ± 0.6 kg (±SEM) in the WELL group and by 4.6 ± 0.6 kg in the LF group (P < 0.001 for both). There was a greater decrease in blood pressure in the WELL group than in the LF group [between-group difference (week 12 –baseline) in both SBP (5.5 ± 1.9 mm Hg; P = 0.006) and DBP (4.4 ± 1.2 mm Hg; P = 0.001)].

Conclusions: For a comparable 5-kg weight loss, a diet high in low-fat dairy products, vegetables, and fruit (the WELL diet) resulted in a greater decrease in blood pressure than did the LF diet. This dietary approach to achieving weight reduction may confer an additional benefit in reducing blood pressure in those who are overweight.

The effect of training in reduced energy density eating and food self-monitoring accuracy on weight loss maintenance

Background:
Failure to maintain weight losses in lifestyle change programs continues to be a major problem and warrants investigation of innovative approaches to weight control.
Objective:
The goal of this study was to compare two novel group interventions, both aimed at improving weight loss maintenance, with a control group.
Methods and Procedures:
A total of 103 women lost weight on a meal replacement–supplemented diet and were then randomized to one of three conditions for the 14-week maintenance phase: cognitive-behavioral treatment (CBT); CBT with an enhanced food monitoring accuracy (EFMA) program; or these two interventions plus a reduced energy density eating (REDE) program. Assessments were conducted periodically through an 18-month postintervention. Outcome measures included weight and self-reported dietary intake. Data were analyzed using completers only as well as baseline-carried-forward imputation.
Results:
Participants lost an average of 7.6 plusminus 2.6 kg during the weight loss phase and 1.8 plusminus 2.3 kg during the maintenance phase. Results do not suggest that the EFMA intervention was successful in improving food monitoring accuracy. The REDE group decreased the energy density (ED) of their diets more so than the other two groups. However, neither the REDE nor the EFMA condition showed any advantage in weight loss maintenance. All groups regained weight between 6- and 18-month follow-ups.
Discussion:
Although no incremental weight maintenance benefit was observed in the EFMA or EFMA + REDE groups, the improvement in the ED of the REDE group's diet, if shown to be sustainable in future studies, could have weight maintenance benefits.

"Lose 30lbs in 30 days" : assigning responsibility for deceptive advertising of weight-loss products

Purpose – The aim of this paper is to outline key social marketing issues apparent in deceptive weight-loss advertising, from the perspective of government policy-makers, manufacturers, the media, and consumers. The purpose is to examine the complexity of one aspect of the obesity battle and provide a framework for coordinated and integrated social marketing initiatives from a multiple stakeholder perspective.

Design/methodology/approach – The results of deceptive weight-loss advertising are framed using the harm chain model, and the paper offers recommended solutions based on a framework of marketing, education and policy changes across the network of stakeholders.

Findings – This paper concludes that a resolution to the harm created by deceptive weight-loss advertising can be achieved by the creation of a more holistic, system-wide solution to this important health and policy issue. This networked approach must involve all aspects of harm in a multi-stakeholder solution, including both upstream and downstream integration. Specific recommendations are made for policy-makers, manufacturers, the media, and consumers to achieve this goal.

Social implications – From a marketing perspective, analyzing the issue of deceptive weight-loss advertising using the harm chain allows for the creation of a more holistic, system-wide solution involving stakeholders in all aspects of harm for this important health and policy issue.

Originality/value – This research examines the problem of obesity and weight-loss advertising from the unique perspective of the harm chain framework. The authors make unified recommendations for various stakeholders including industry, media, government and consumers, in order to direct integrated social marketing and consumer-oriented strategies within this industry.

Interleukin-10 inhibits bone resorption: a potential therapeutic strategy in periodontitis and other bone loss diseases

Periodontitis and other bone loss diseases, decreasing bone volume and strength, have a significant impact on millions of people with the risk of tooth loss and bone fracture. The integrity and strength of bone are maintained through the balance between bone resorption and bone formation by osteoclasts and osteoblasts, respectively, so the loss of bone results from the disruption of such balance due to increased resorption or/and decreased formation of bone. The goal of therapies for diseases of bone loss is to reduce bone loss, improve bone formation, and then keep healthy bone density. Current therapies have mostly relied on long-term medication, exercise, anti-inflammatory therapies, and changing of the life style. However there are some limitations for some patients in the effective treatments for bone loss diseases because of the complexity of bone loss. Interleukin-10 (IL-10) is a potent anti-inflammatory cytokine, and recent studies have indicated that IL-10 can contribute to the maintenance of bone mass through inhibition of osteoclastic bone resorption and regulation of osteoblastic bone formation. This paper will provide a brief overview of the role of IL-10 in bone loss diseases and discuss the possibility of IL-10 adoption in therapy of bone loss diseases therapy.

Weight management and weight loss strategies of professional jockeys

Jockeys are required to maintain very low body weight and precise weight control during competition. This study examined the weight loss and weight management strategies of professional horseracing jockeys in the state of Victoria, Australia. An anonymous, self-completed questionnaire was administered (55 % response rate, n = 116). Almost half (43 %) reported that maintaining riding weight was difficult or very difficult, with 75 % routinely skipping meals. In preparation for racing, 60 % reported that they typically required additional weight loss, with 81 % restricting food intake in the 24 hours prior to racing. Additionally, sauna-induced sweating (29 %) and diuretics (22 %) were frequently employed to further aid in weight loss prior to racing. These rapid weight loss methods did not differ between the 51 % of jockeys who followed a weight management plan compared to those who did not. The impact of these extreme weight loss practices on riding performance and health remains unknown.

Focus group study of endometriosis: struggle, loss and the medical merry-go-round

Women with endometriosis experience a range of problems for which they may or may not be adequately supported. This paper reports on one aspect of a study conducted at the Epworth Hospital, Melbourne, to identify the information needs of women facing laparoscopy for endometriosis. A number of focus groups were conducted that provided women with a forum for communicating their experiences of endometriosis and laparoscopy. The findings include the experiences of 61 women who described the lack of support, the struggles and the losses involved in living with endometriosis. By far the worst experience that these women described was the encounter with health professionals and the ways in which their symptoms were trivialised and dismissed. There is a great deal for nurses to learn about the experience of living with endometriosis if they are to support women with this chronic illness in their search for well-being.

Sociocultural and individual influences on muscle gain and weight loss strategies among adolescent boys and girls

The study examined the role of body dissatisfaction, body image importance, sociocultural influences (media and parent and peer encouragement), self-esteem and negative affect on body change strategies to decrease weight and increase muscles in adolescent boys and girls. Surveys were administered to 587 boys and 598 girls aged between 11 and 15 years. For both genders, parent and peer encouragement and negative affect were the primary predictors of body dissatisfaction, body image importance and strategies to decrease weight and increase muscles. In addition, body image importance was a significant factor in the development of both types of body change strategies, while the media only predicted strategies to decrease weight. Lastly, the effects of self-esteem were mediated by body dissatisfaction. For boys, a stronger focus on body importance occurred among the boys who were generally satisfied with their bodies while the reverse was the case for girls.

Loss, grief and representation: "Getting on with it"

This paper is concerned with the social, spiritual and expressive ways of dealing with the pain of grief over loss of objects, of relationships, of persons, of the self. Dominant twentieth century medical and clinical models have assumed that grief will be "resolved" when survivors reach the point where they can emotionally detach themselves from the dead person. Freudian psychoanalysis sees mourning as a process necessary for survival It enables the bereaved to grieve by "letting go" of and "breaking the attachment" to the lost person or object. By contrast, melancholia involves the refusal to let go, sometimes leading to pathological outcomes. The melancholic figure, in popular perception, is often identified as a romantic symbol of the connection between insanity and creative genius. This paper argues that there is an interim space between detachment and pathological immersion. Contrary to detachment being necessary for creative remodelling of the experience of death through art-making, our psychological preservation actually requires continuity, not detachment, and the construction of biographical narratives of all kinds is a fundamental mechanism for restoring a sense of meaning and place for the dead and lost in the ongoing trajectory of self-narrative.

Is the treatment of economic loss by the Australian courts in torts cases anomalous?

The well developed economic theory of tort liability has never been able to comfortably accommodate negligence cases causing pure economic loss as opposed to physical damage or injury. In fact, contrary to received opinion, Australian Courts at least, are increasingly allocating pure economic losses to achieve predominantly an efficiency objective, with corrective justice notions relegated into the background. Consequently, it is difficult to classify these cases as anomalous in the sense of falling outside the efficiency paradigm.

The importance of pet loss and some implications for services

Understanding the meaning of companion animals and their loss in peoples' lives has major implications for the way professional services are organized and delivered. There is much research and literature which argues for the major social, emotional and physical benefits of animal companionship, and the widespread nature of pet ownership. Yet ironically, much of the professional service literature has tended to marginalize or pathologize the human-animal bond, often dichotomizing it against human relationships and assuming its inferiority. We argue that this reflects a tendency to individualize what should be a major social concern. Therefore service design and delivery needs to reflect a recognition of human-animal relationships as a significant part of normal experience. Services and policies need to factor in both the inclusion and loss of these.